NPIMap

Organization Active NPI

Piedmont Psychological Services

  • Clinical Psychologist
  • Farmville, VA
National Provider Identifier
1104120294
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810001049 Issued in VA
Legal business name
PIEDMONT PSYCHOLOGICAL SERVICES
Practice address
200B Milnwood Rd
Farmville, VA 23901-2817
Phone
(434) 315-8813
Fax
(434) 315-5913
NPI assigned
Jan 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Lynn Carson Blackwood Jr., PH.D.NPI 1366512881
Title
Licensed Clinical Psychologist
Phone
(434) 315-8813

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 0701003954 VA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 0810001049 VA Primary

Addresses

Primary practice location

200B Milnwood Rd
Farmville, VA 23901-2817

Mailing address

200B Milnwood Rd
Farmville, VA 23901-2817
Phone (434) 315-8813

National Provider Directory

National Provider Directory

Locations

200B Milnwood Rd
Farmville, VA 23901
Phone (434) 314-8813

309 Beech St
Farmville, VA 23901

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1104120294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200B MILNWOOD RD",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012817",
            "telephone_number": "434-315-8813",
            "fax_number": "434-315-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200B MILNWOOD RD",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239012817",
            "telephone_number": "434-315-8813",
            "fax_number": "434-315-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "BLACKWOOD",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "CARSON",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "434-315-8813",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003954",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.